Individual provider Active NPI

Krystle Marie Nelson

  • Registered Nurse
  • Seattle, WA
National Provider Identifier
1952069189
Registry record updated Dec 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60741716 Issued in WA
Practice address
1505 Westlake Ave N Ste 400
Seattle, WA 98109-6211
Phone
(206) 301-5000
NPI assigned
Dec 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60741716 WA Primary

Addresses

Primary practice location

1505 Westlake Ave N Ste 400
Seattle, WA 98109-6211

Mailing address

5858 Poppy Hills St SE
Salem, OR 97306-9011
Phone (509) 264-6939

Other names 1

  • Krystle Marie Holcomb Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN60741716WAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1952069189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 POPPY HILLS ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973069011",
            "telephone_number": "509-264-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WESTLAKE AVE N STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981096211",
            "telephone_number": "206-301-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KRYSTLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60741716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "HOLCOMB",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.